Abstract
Magnetic resonance imaging-guided focused ultrasound (MRgFUS) surgery is a noninvasive, image-guided therapeutic method that integrates focused ultrasound (FUS), the therapeutic component, with magnetic resonance imaging (MRI), the image-guidance component, into a real-time therapy delivery system. High intensities, resulting in localized heating due to absorption of the acoustic wave, can be achieved in the focal zone without damaging the surrounding tissues. MRI is used preoperatively for target definition and treatment planning, intraoperatively for procedure monitoring and control, and postoperatively for treatment validation. Main applications for MRgFUS to date are for symptom relief for uterine fibroids and bone metastases with oncological applications under investigation for breast, liver, and prostate cancer. In our view, the most promising application for this technology will be in the brain, and they are thermal ablations for brain tumors and functional neurosurgery, and nonthermal, nonablative uses for disruption of the blood-brain barrier (BBB) or blood clot and hematoma dissolution by liquification as well as the promising application of neuromodulation. The disruption of the BBB by FUS can be used for targeted delivery of therapeutic agents including potentially genes or even stem cells. This article reviews the current status of these different treatments for this unique technology.
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